Decreasing susceptibility of bacteria to ampicillin/ sulbactam and third generation cephalosporins in urinary tract infections

Vallo, Stefan; Wirth, Patrick; Kukic, Adnan; Nafez, Omar; Neagoe, Ladislau; Nestler, Sebastian; Jones, Jon W.

doi:10.1097/cu9.0000000000000079

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Basically, time-dependent variations in the proportions of UTI isolates have been reported by several investigators [23]. In a recent study, Vallo et al reported a signi cant increase in the percentage of E. coli over time (2011 -2015) [24]. Similarly, Van driel et al found an increase from 0.1% in 2004 to 2.2% in 2014 (p-value < 0.05) in the prevalence of ESBL-producing E. coli from 30 general practitioner practices in the Netherlands [25].…”

Section: Discussionmentioning

confidence: 83%

Patterns and trends of antimicrobial resistance in bacterial isolates from urine cultures in Eritrea, 2010–2021: a secondary dataset analysis

Garoy,

Ghebrehiwet,

Fessehaye

et al. 2024

Preprint

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Background: Although the threat posed by antibacterial resistance (AMR) in urinary tract infections (UTI) is well documented; significant knowledge gaps remain for most countries in sub-Saharan Africa. In this study, we set out to describe the most common uropathogens in Eritrea. The magnitude, trends, and factors associated with AMR and MDR were also assed. Methods: A retrospective record review of data (January 2010 - 2021) collected from all urine samples from patients from multiple treatment centers in Eritrea and analysed at the microbiology department at the National Reference Laboratory (NHL) was undertaken. Main outcomes included patient characteristics, magnitude of AMR, MDR, and associated patterns and trends. SPSS was used for statistical analysis, and Microsoft Excel was used to plot figures. Results: Our analysis indicates that 64.9% (1940) of the patients were male; median age (IQR) was 50 years (35-58 years); and > 50% of the age range of patients were in the 36 to 65 year age band. Antibiotic susceptibility was stable over time except for ciprofloxacin (96% in 2004, 97% in 2009, and 94% in 2014; P < 0.05). With decreasing frequency, the most common isolates were UPEC (39.7%, n=1,190); Kliebsiella spp. (10.7%, n=322), Citrobacter spp. (8.7%, n=260), Enterobacter spp.(7.1%, n=213), Proteus spp. (7%, n=209), Streptococcus Group D (6.5%, n=194) and Pseudomonas aeruginosa(6.4%, n=193). The prevalence of AMR in UTI is high with a strong involvement of ESKAPE organisms. A high proportion (2414 (80.5%)) of MDR (and potentially uropathogens from XDR and PDR) was also reported. Furthermore, a MAR index > - 2 in GNB was obtained in 81.1% of the isolates. Although age and the presence of indwelling devices were significantly associated with the probability of MDR in the aPR; the relationship was attenuated in the uPR. Finally, only sex (higher in males: uPR: 2.97) and isolates of a specific genus were associated with MDR. Compared to UPEC, the probability of MDR followed the following sequence: Pseudomonas aeruginosa > (uPR: 16.9) > Proteus spp. (uPR: 5.2) > other GNBs (uPR: 2.1) > Citrobacter spp (uPR: 1.67). Interestingly, all GPBs (S. aureus, Streptococcus group D) had a reduced likelihood of MDR. Conclusion: We identified a high and increasing prevalence of AMR and MDR in patients with UTI in Eritrea. The findings emphasize the urgent need to address gaps in laboratory infrastructure, AST testing strategies, AMR surveillance, infection control, reporting, and the use of locally generated data to optimize treatment guidelines.

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Section: Discussionmentioning

confidence: 83%

Patterns and trends of antimicrobial resistance in bacterial isolates from urine cultures in Eritrea, 2010–2021: a secondary dataset analysis

Garoy,

Ghebrehiwet,

Fessehaye

et al. 2024

Preprint

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“…Urinary tract infections were confirmed by a single bacterial species in the urine specimen reaching a concentration of 10 5 CFU/mL. 17,18 https://doi.org/10.2147/IDR.S424158…”

Section: Bacterial Culturementioning

confidence: 99%

Patterns of Drug Resistance and Bacterial Pathogen Distribution in Patients with Urinary Tract Infections in the Jiaxing Region from 2020 to 2022

Niu,

Hou,

Yang

et al. 2023

IDR

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Background Urinary tract infections (UTIs) and the antibiotic resistance of pathogenic bacteria pose severe threats to public health in the current healthcare environment. Objective The purpose of this study was to assess the frequency distribution of bacterial pathogens causing UTIs as well as the characteristics of antibiotic susceptibility and resistance. Methods The retrospective study was conducted on 32,391 samples of midstream urine culture from January 1, 2020, to December 31, 2022, in Jiaxing. Bacteria were cultivated on blood agar and identified using MALDI-TOF, and their susceptibility to different antibiotics was assessed using the Kirby-Bauer disk diffusion method and drug sensitivity reaction cards. The SPSS 22 software was used for data analysis. Bivariate logistic regression was used to analyze the risk factors for multidrug resistance. Results The total number of positive growth samples was 5378 (16.6%), including 3206 females (59.6%) and 2172 males (40.4%). The four most common urinary pathogens were Escherichia coli (39.2%), Enterococcus faecalis (12.4%), Klebsiella pneumoniae (7.6%), and Enterococcus faecium (7.6%). As far as antibiotic resistance was concerned, Escherichia coli had a greater than 50% resistance rate to ampicillin (76.1%), ciprofloxacin (58.6%), and levofloxacin (51.2%). The multidrug resistance rate was high (41.8%). Low levels of resistance were seen to ertapenem (0.1%), imipenem (0.7%), meropenem (0.7%), piperacillin/tazobactam (0.7%), and nitrofurantoin (1.8%). Klebsiella pneumoniae was highly sensitive to ertapenem (100%). The resistance rates to nitrofurantoin, ceftriaxone, and ciprofloxacin were 37.4%, 37.1%, and 35.1%, respectively. Up to 41% of Escherichia coli strains and 26% of Klebsiella pneumoniae strains produced extended-spectrum lactamases (ESBL). Two species of enterococci were highly sensitive to tigecycline and linezolid (100%), and a small number of norvancomycin-resistant strains (0.2%/two strains) were found. Conclusion Escherichia coli and Enterococcus faecium were the most common urinary pathogens in this study. The isolated pathogens showed different sensitivity patterns. Antibiotics should be selected reasonably according to the sensitivity mode of pathogenic bacteria to effectively treat and prevent urinary tract infections.

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Carrier-Free Small Molecule-Assembled Nanoparticles for Treatment of Sepsis

Xing,

Sheng,

et al. 2024

ACS Appl. Nano Mater.

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Sepsis is a complex disorder with high morality. Overabundant inflammation can result in organ dysfunction, leading to a series of diseases. Drug delivery systems have improved drug efficacy and brought hope for sepsis treatment. However, the usage of various inorganic and organic carriers might increase the potential toxicity of nanoparticles (NPs) and make their clinical transformation more difficult. Rhubarb and epimedium show good anti-inflammation and metabolic disorder treatment potentials. A series of ingredients that can form nanoscale particles without any additives were found in rhubarb and epimedium decoction. Based on pharmacological activity and cost-effectiveness consideration, rhein and icariin were selected to self-assemble to construct NPs. The prepared NPs show good anti-inflammatory properties and alleviate ferroptosis in vitro and in vivo. Further research has found that the prepared rhein–icariin NPs (R–I NPs) mainly prolong the survival time of mice by maintaining the kidneys’ function in sepsis, which is consistent with the function of their formulation Compound rhubarb granule. The prepared carrier-free, safe, and traditional Chinese medicine (TCM)-derived NPs show great potential in drug delivery. This study also provides a safe and simple nanoplatform to treat sepsis, which may pave a way to design TCM-derived NPs for clinical translation.

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Decreasing susceptibility of bacteria to ampicillin/ sulbactam and third generation cephalosporins in urinary tract infections

Cited by 3 publications

References 21 publications

Patterns and trends of antimicrobial resistance in bacterial isolates from urine cultures in Eritrea, 2010–2021: a secondary dataset analysis

Patterns and trends of antimicrobial resistance in bacterial isolates from urine cultures in Eritrea, 2010–2021: a secondary dataset analysis

Patterns of Drug Resistance and Bacterial Pathogen Distribution in Patients with Urinary Tract Infections in the Jiaxing Region from 2020 to 2022

Carrier-Free Small Molecule-Assembled Nanoparticles for Treatment of Sepsis

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